Friday, February 27, 2009


I think the common concept of "human nature" is misnamed.

"It's just human nature," we often hear, when a person is self-seeking, or catty, or makes a mistake.  Yet we also say that positive traits "humanize" people.  

I think what we tend to call "human nature" is just the opposite - inhuman, our dark side:  tendencies of a baser, de-humanized sort.  This is my concept of "original sin":  not a stain passed on magically from one generation to the next because of some disobedience over a piece of fruit, but rather, the tendency to fail to be more than the sum of our various parts - hormones, neurotransmitters, drives, dopamine cravings.  I think being fully human means being able to transcend this native machinery and rise above it, create more with it.

Which is why when a surgeon said this today, I was mightily disappointed indeed:

[Responding behind the anesthesiologist's back after she walked into the room to ask if he wanted a medicine consult for one of his patients, then walked out again]:  

"Why doesn't anesthesia just see the patient, so they can pretend they're doctors." 

Now, how does someone sink to such a disrespectful low, especially about a fellow-physician - and not just any fellow-physician, but the kind that actually CARES about a patient's pre-op medical problems and intra-op safety?  What can explain his snide attitude?  Lack of proper parenting?  Misplaced arrogance and entitlement?  Exhaustion from a frustrating day?  All the above? Would he want anyone to speak to or about his family, friends, spouse, or children that way?

As far as I'm concerned it's not "human" at all to be nasty.  It's base.  It says more about the speaker than about his subject. As problematic as the St. Boonie's job became in the end, this kind of talk would generally not have happened there; the surgeons, for the most part, were too good for that - as people and as surgeons.  I miss that.

Another example:  some kids at my daughter's school have been fabricating and repeating rumors about her in the wake of her getting cast as Annie.  According to her teachers and her friends, most people see her as a sweet, funny, thoughtful, outgoing, and wholesome kid who hangs out with other kids of the same ilk.  But there are those in the class who have actually said to her face, "Hey, did you bribe the music director to get the part?"  She has received some cat-calling and been told some people are spreading around the risible suggestion that she is, as she says in code, "you know - a female dog."  I am both completely un-surprised and profoundly disgusted by the behavior of some of her more spoiled, jealous, mean-spirited peers.  

I told her to give them no reason whatsoever to accuse her of anything but kindness.  I also told her there are two things that seem to be able to show us who our true friends are:  success and failure (or suffering).  Her true friends have rallied around her and seem to be keeping her grounded and feeling supported. This, to me, is fully human, truly human, behavior.


Unknown said...

Some people have a black heart.

marisa said...

i thought you should've confronted the surgeon and taught him some manners. the next time somebody says that about your specialty, you ought to challenge them to operate without your expertise. i'm sure they won't be stupid enough to actually try operating without a qualified anaesthesiologist.

T. said...

QuietusLeo - YES, it's true.

Which is why...

Marisa - I thought about saying something to the surgeon, but decided against it.

I value defending our profession, I really do. But I've also met enough of this type of surgeon to know that confronting them with their own flaws achieves NOTHING - it just causes further alienation in a relationship already marred by their attitudes. Such a confrontation, made publicly, can also degenerate into a battle of wills that brings you not to common understanding and better mutual respect but rather a tense impasse that forever sets the tone of future interactions. Experience has shown that people like him really can't do better in the acute phase; they're too un-seeing and unwilling.

I plan on a more long-term way of addressing this (much less satisfying, and requiring a ton of patience which is NOT one of my virtues, but I'm hoping more effective and more lasting in the long-run). I am new there. He doesn't know me or my work. His patients will get from me consistently professional behavior, competence, and compassion, and they will do well under his knife. When there are medical questions to be answered, I'll be the knowledgeable consultant I was trained to be. My attitude will be impeccable. There is nothing, then, that he'll be able to say over time to accuse me of being anything other than a true and good physician, and if his attitude persists, then it was hopelessly black-hearted to begin with, and I will have lost nothing but stayed true to myself and my values.

We'll see how that goes. I'm already telling myself with not a little sarcasm, "Yeah, good luck with that!" :)

marisa said...

it's great that you're choosing that option, i do wish you all the best with it. i conveniently forgot you were still settling into your new job when i posted the comment.. in that light, yes my suggestion does seem rather rash now. i'm really impressed with the approach you're taking with your daughter, as well as practicing it yourself. i'll need to cultivate some patience myself! :)

Map said...

I pity such people who are so wrapped up in themselves that they must lash out in anger.

Good for you for taking the high road. You have my utmost support in your long term plan -which is, as you said, how you would act and perform anyway, even if that surgeon had not expressed such animosity. And good for you for teaching your daughter the same attitude.

Lisa Johnson said...

Wow. I had to catch my breath when I read the first comment about a "black" heart. It reminded me of the post that I wrote about the negative connotations of the word black. Wow. Anyway...

I'm glad that your daughter has such good friends who are showing her their most human nature.

T. said...

Anali - I must confess that when I saw the phrase "black heart" I had zero alarms go off on my racism-radar. The only images that came to mind were those of (white)villains from favorite stories - Chauvlin from The Scarlet Pimpernel, Iago from Othello, the evil pirate in Pirates of the Caribbean - folks with basically un-wholesome intentions. Perhaps it's because as a child I read Joan Aiken's "Black Hearts in Battersea" and enjoyed the battle of good versus evil - the "Dark Side" - in Star Wars, and thought of that imagery strictly as literary stuff without any racist impregnation?

There's such a long history - probably thousands of years old - of using imagery and language of "darkness" and "blackness" to represent sinister doings or tendencies in literature - any activity or character that will not admit or reflect "light," which so often in poetry and other kinds of literature connotes goodness / beauty / truth / what-have-you. I honestly did not receive that first comment with and racially-sensitive sensibilities because I have never juxtaposed that literary use of the color with the use of the word as a descriptor for skin tone - that just NEVER occurred to me in all my years of reading books and poems from around the world. But I'm glad you've pointed out that such imagery and language can be quite loaded; if I was insensitive to that, I imagine others who have not had to deal with black/white racism might also fail to think of it. I think for many of us an automatic negative connotation for EVERY use of the word black just does not exist; it just depends on the literary / social context.

We all have much to learn about how language can become a loaded thing. Thank you for making a valuable point that all of us should definitely think about. I think the post you emailed me about is a great starting point: Thanks for sending that!

Unknown said...

I wrote "black" to refer to the hue even though it is also a color (oooops!). You Yanks are so touchy.

T. said...

Interesting...having "a black heart" is such an acceptable metaphor to me, but somehow I'm not wild about the phrase "You Yanks" (not meaning to prove your point or anything...).

Maybe because I'm not a Yank? Or because it strikes me as similar to saying "You people" or "These people" in a pejorative or marginalizing way?

Jo said...

First of all - lots of {hugs} for your daughter - I'm sorry that she is having to go through such bullying over her success (though my sister, who is in her final year of a drama degree, tells me that this is not uncommon - jealousy rears its ugly head!)

Secondly - I finished reading Marcus Aurelius' Meditations before Christmas. I can't remember the exact quotes (though I will try to find them if you want me to), and therefore can't post a link, but some of his thoughts ran along these lines:

Every day, you will come across people who, through maliciousness, ignorance or thoughtlessness, will do or say something that will hurt you or make you angry. This behaviour is part of their nature (though not Human nature), and the only way that they "win" is if they manage to make you change your own nature and react to them (by being hurt / angry). So, instead, you should feel sorry for them, because they obviously do not know how to behave as humans, and therefore will be unhappy inside, as their nature is so at odds with the perfect human nature.

Whilst I find it sometimes really difficult to follow MA's philosophy (sometimes I think that getting angry is a good way of starting to fight things like injustice etc), I find that the above paraphrasing does help, particularly when you come across people who are genuinely unpleasant for the sake of it, and also for those idiots who cut you up in traffic! ;-)

T. said...

Jo, thanks for the wonderful paraphrase - I've emailed it to my daughter so she can enjoy it too. We appreciate the support! :)

Anonymous said...

"I told her to give them no reason whatsoever to accuse her of anything but kindness."

Absolutely. Tell her I'm thinking about her!!

Also, have you read "Queen Bees and Wannabes"? We're not there yet, but it's on my list for next year in dealing with the middle school bullying business.

Anonymous said...

What a hurtful jerk. And a bully.

Do you have someone established at your new workplace and higher up in the pecking order, preferably your boss, who you can vent to? I think you should talk to him/her to find out the scoop on this guy. You shouldn't have to feel alone, and $20 says you aren't his first (or last) victim. Is there some "history" between this individual and your group (anesthesiologists) that you don't know about because you're the new kid on the block?

I hope he's not abusive like this in the operating room, because undermining team members' confidence certainly isn't good for the poor patients. But it sounds like your instincts are telling you that there might be bigger political issues between the surgeons and others.

BTW, I remember your wonderful post about using a special technique to help ventilate a patient. I would have some choice words for this chap, but I'm afraid you would classify me as "subhuman"! ;-)

-Transor Z

T. said...

Transor Z - this surgeon's behavior was so MILD compared to what they can so often be capable of. And this WAS in the operating room!

Oh well...such is our life...

T. said...

Katy - I'm going to have to check that book out. Am loving all your advice, both "onstage" and "offstage." Thank you so much!

Anonymous said...

wrt the racial and ethnic differences which obviously exist between us, perhaps clint eastwood in a recent interview provides a more enlightened view -- because it transcends; rises above and disarms the issue with humor -- than the one presently prevailing:

"People have lost their sense of humor. In former times we constantly made jokes about different races. You can only tell them today with one hand over your mouth or you will be insulted as a racist. I find that ridiculous. In those earlier days every friendly clique had a "Sam the Jew" or "Jose the Mexican" — but we didn't think anything of it or have a racist thought. It was just normal that we made jokes based on our nationality or ethnicity. That was never a problem. I don't want to be politically correct."

the climate he describes seems far more wholesome than ours; i fear we've devolved.